Individual
FELISSA P GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202
(502) 588-0800
(502) 588-0801
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
057467
GA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
38619
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100403480
—
KY
05
—
810960817A
—
GA
01
—
K179240
KY MEDICARE
KY
Enumeration date
10/17/2006
Last updated
07/27/2020
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